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Effects of non-invasive brain stimulation on walking and balance ability in Parkinson's patients: A systematic review and meta-analysis.

作者信息

Zhang Xinxin, Jing Feiyue, Liu Yu'ang, Tang Jinyong, Hua Xianfeng, Zhu Jialin, Tuo Haowen, Lin Qihan, Gao Pincao, Liu Weiguo

机构信息

College of Physical Education and Health, Guangxi Normal University, Guilin, China.

出版信息

Front Aging Neurosci. 2023 Jan 10;14:1065126. doi: 10.3389/fnagi.2022.1065126. eCollection 2022.


DOI:10.3389/fnagi.2022.1065126
PMID:36704502
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9871558/
Abstract

OBJECTIVE: To investigate and contrast the effects of non-invasive brain stimulation (NIBS), including repeated transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), on walking and balance ability in patients with Parkinson's disease (PD). METHODS: The PubMed, Embase, Medline, Cochrane, CNKI, and Chinese WanFang databases were searched up to June 2022. Quality assessment was performed using the Cochrane Collaboration's risk-of-bias guidelines, and the standardized mean differences (SMD) or mean differences (MD) for each outcome were calculated. RESULTS: Among 32 eligible studies, including 1,586 participants were analyzed in this meta-analysis. The results of the meta-analysis showed that NIBS was effective in improving UPDRS-III scores (MD = -2.07; 95% CI, -2.62 to -1.53; < 0.00001; = 6%) and variables associated with the ability of walk such as step width (SMD = 0.35; 95% CI, 0.16-0.55; = 0.0005; = 38%), cadence (SMD = 0.3; 95% CI, 0.05 to 0.55; = 0.02; = 25%), and 6MWT (MD = 62.86; 95% CI, 39.43-86.29; < 0.00001; = 0%). In subgroup analyses across intervention types, UPDRS-III scores (rTMS: MD = -2.54; 95% CI, -3.16 to -1.92; < 0.00001; = 0%; tDCS: MD = -1.20; 95% CI, -1.99 to -0.40; = 0.003; = 0%) and TUGT time (rTMS: MD = -4.11; 95% CI, -4.74 to -3.47; < 0.00001; = 0%; tDCS: MD = -0.84; 95% CI, -1.48 to -0.21; = 0.009; = 0%) significantly improved. Moreover, our results also showed that compared to tDCS, rTMS was more significant in improving UPDRS-III scores and TUGT time ( < 0.05). CONCLUSION: NIBS benefits some walking ability variables but not balance ability in 36 patients with PD. The rTMS significantly improved UPDRS-III scores and TUGT time compared to tDCS. Further studies are needed to determine the optimal protocol and to illuminate effects based on the ideal target brain regions, stimulation intensity, timing, and type of intervention. SYSTEMATIC REVIEW REGISTRATION: http://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022350782.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/d4ae8530b60b/fnagi-14-1065126-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/e410e4601f23/fnagi-14-1065126-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/2cd06f8f9173/fnagi-14-1065126-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/bb07724a112e/fnagi-14-1065126-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/82eff20c1140/fnagi-14-1065126-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/27fe0a1e7181/fnagi-14-1065126-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/3c558ee53d1d/fnagi-14-1065126-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/e4058444e621/fnagi-14-1065126-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/0f9cd3c05c61/fnagi-14-1065126-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/9028b4ef4495/fnagi-14-1065126-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/ec2de4d9a3a6/fnagi-14-1065126-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/d4ae8530b60b/fnagi-14-1065126-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/e410e4601f23/fnagi-14-1065126-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/2cd06f8f9173/fnagi-14-1065126-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/bb07724a112e/fnagi-14-1065126-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/82eff20c1140/fnagi-14-1065126-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/27fe0a1e7181/fnagi-14-1065126-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/3c558ee53d1d/fnagi-14-1065126-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/e4058444e621/fnagi-14-1065126-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/0f9cd3c05c61/fnagi-14-1065126-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/9028b4ef4495/fnagi-14-1065126-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/ec2de4d9a3a6/fnagi-14-1065126-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83aa/9871558/d4ae8530b60b/fnagi-14-1065126-g011.jpg

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[4]
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[5]
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[6]
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[7]
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[8]
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本文引用的文献

[1]
Effects of repetitive transcranial magnetic stimulation on gait disorders and cognitive dysfunction in Parkinson's disease: A systematic review with meta-analysis.

Brain Behav. 2022-8

[2]
Transcranial Direct Current Stimulation on Different Targets to Modulate Cortical Activity and Dual-Task Walking in Individuals With Parkinson's Disease: A Double Blinded Randomized Controlled Trial.

Front Aging Neurosci. 2022-2-7

[3]
Transcranial Direct Current Stimulation on Parkinson's Disease: Systematic Review and Meta-Analysis.

Front Neurol. 2022-1-10

[4]
Efficacy of repetitive transcranial magnetic stimulation for improving lower limb function in individuals with neurological disorders: A systematic review and meta-analysis of randomized sham-controlled trials.

J Rehabil Med. 2022-2-3

[5]
Effect of liuzijue qigong on patients with stable chronic obstructive pulmonary disease: A systematic review and meta-analysis.

Medicine (Baltimore). 2021-10-15

[6]
The effects of transcranial direct current stimulation on gait in patients with Parkinson's disease: a systematic review.

Transl Neurodegener. 2021-6-29

[7]
Transcranial direct current stimulation provides no clinically important benefits over walking training for improving walking in Parkinson's disease: a systematic review.

J Physiother. 2021-7

[8]
Efficacy of non-invasive brain stimulation on cognitive functioning in brain disorders: a meta-analysis.

Psychol Med. 2020-11

[9]
Transcranial magnetic stimulation and gait disturbances in Parkinson's disease: A systematic review.

Neurophysiol Clin. 2020-7

[10]
Does transcranial direct current stimulation improve functional locomotion in people with Parkinson's disease? A systematic review and meta-analysis.

J Neuroeng Rehabil. 2019-7-8

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